Intrauterine devices (IUDs) are small, T-shaped devices placed inside the uterine cavity that provide highly effective contraception for years without requiring any daily action. With failure rates below 1 percent per year — comparable to sterilization — IUDs are the most effective reversible contraceptive methods available. They are immediately reversible upon removal, fertility returns promptly, and they are appropriate for most women regardless of age or prior pregnancy history.
Two categories of IUD are available: hormonal IUDs that release small amounts of progestin locally, and the copper IUD which provides hormone-free contraception. Each has distinct characteristics that make it better suited to different situations.
Mirena — 8 Years, Highest Progestin Dose
Mirena releases 20 mcg levonorgestrel daily and is approved for up to 8 years of use. It is also FDA-approved for the treatment of heavy menstrual bleeding. Most Mirena users have significantly lighter periods or no periods at all after the first several months. Mirena is one of the most effective management tools for heavy periods, endometriosis-related bleeding, and adenomyosis — in addition to its contraceptive function. It is the largest of the hormonal IUDs and is typically the preferred option for women who have delivered children vaginally.
Kyleena — 5 Years, Lower Progestin, Smaller Size
Kyleena releases 17.5 mcg levonorgestrel daily and is approved for 5 years. It is slightly smaller than Mirena and is a good option for women with a smaller uterine cavity, including nulliparous women. Periods typically become lighter but are more likely to continue than with Mirena.
Liletta — 8 Years, Similar to Mirena
Liletta releases 18.6 mcg levonorgestrel daily and is approved for 8 years. It is similar in size to Kyleena and provides equivalent contraceptive effectiveness to Mirena. It is often more affordable than Mirena, which may be relevant for uninsured or underinsured patients.
Skyla — 3 Years, Smallest Hormonal IUD
Skyla releases 14 mcg levonorgestrel daily and is approved for 3 years. It is the smallest of the hormonal IUDs and was specifically designed for women who have not been pregnant. Periods continue in most users, though typically lighter. Its shorter duration may appeal to women who are uncertain about longer commitments or who may want to conceive within 3 to 5 years.
Paragard — Copper IUD, Hormone-Free, 10 Years
Paragard is the only non-hormonal IUD available and is approved for up to 10 years — making it the longest-acting reversible contraceptive available. Copper ions are spermicidal and prevent fertilization without any hormonal mechanism. It is also the most effective emergency contraceptive when inserted within 5 days of unprotected intercourse. The copper IUD typically increases menstrual flow and cramping, particularly in the first several months. It is the preferred option for women who cannot or prefer not to use hormonal methods.
Contact our office the same day if after IUD insertion you experience:
- Fever above 38°C (100.4°F) — may indicate infection
- Severe pelvic pain beyond the expected cramping of the first day or two
- Heavy vaginal bleeding significantly beyond a normal period
- Inability to feel the IUD strings when you expect to, combined with any discomfort
Before the Procedure
The consultation reviews which IUD type is most appropriate based on your health history, reproductive goals, and uterine anatomy. Timing of insertion is discussed — insertion during the menstrual period is often preferred because the cervix is slightly more open and pregnancy can be excluded. Pain management options including oral ibuprofen taken before the procedure and in some cases cervical preparation are reviewed. Pregnancy must be excluded before insertion.
During the Procedure
The insertion procedure takes approximately 5 to 10 minutes. A speculum is placed, the cervix is cleansed, the uterine depth is measured with a small instrument (sound), and the IUD is inserted through the cervix into the uterine cavity using the insertion tube. Cramping during and immediately after insertion ranges from mild to significant depending on the individual. Most women describe it as strong menstrual cramps that resolve within minutes to hours. Dr. Andrei discusses what to expect specifically before beginning.
After Insertion
Cramping and light spotting are normal for the first few days after insertion. The IUD has two thin strings that extend through the cervix into the vaginal canal — you can check these yourself monthly to confirm the IUD is in place. A follow-up visit is scheduled 4 to 6 weeks after insertion to confirm correct placement and address any concerns. Most women return to normal activities the same day.
Many women who would benefit most from an IUD — nulliparous women, teens, women with heavy periods, women who have had difficulty with daily pill adherence — have been told they are not eligible based on outdated information. Current guidelines support IUD use across age groups and reproductive histories. If you have been told you cannot have an IUD, that recommendation is worth revisiting with a clinician who is current on the evidence.
Dr. Ramona D. Andrei and the team at Lapeer Women’s Health are here for that conversation — at both our Lapeer and Rochester Hills offices, without a referral required.
Dr. Andrei performs IUD insertions at both our Lapeer and Rochester Hills offices. No referral required.
Schedule a Gynecologic VisitEducational purposes only. Not medical advice. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.